Care Home: Whitehaven

What the care home does well This is the first inspection carried out and is considered a new service. Residents at Whitehaven enjoyed a relaxed atmosphere and appeared comfortable in their surroundings. The manager who also owns the home and the staff team were friendly and welcoming. Residents said they found them all responsive, helpful and approachable, and that they would have no hesitation in taking any concern they might have to the staff team. The care home was comfortable and clean, although some areas still require a tidy up. The owners have totally replaced the kitchen resulting in a five star rating from the Environmental Health. Residents had been encouraged to personalise their own rooms and those that were seen contained a mix of their own personal possessions and furniture provided by the owner. Prospective residents are provided with good information to read prior to moving in, and are visited by the manager to assess their individual needs. A care plan of their individual care, social and personal needs is written by the manager and monitored regularly by the staff to ensure that the service can continue to meet their needs. Any complaints are listened to and acted upon appropriately. The AQAA (Annual Quality Assurance Assessment) states that the new owners have carried out a survey obtaining opinions from residents regarding different aspects of the home and through this survey changed some aspects of food choices and activity times. What has improved since the last inspection? This is the first inspection carried out since the change of ownership, which is classed as a new service. What the care home could do better: There were no requirements issued at this visit although, some recommendations were discussed with the manager to consider improvements for the residents. The manager should organise the local library to visit to offer books for residents to read. There are still some areas of the home that require redecoration and improvement such as the dining room and upstairs bathroom. The manager should consider adapting space to provide an office or area that confidential meetings can take place, rather than the current practice of using the communal rooms. Key inspection report Care homes for older people Name: Address: Whitehaven 5 St. Josephs Road Sheringham Norfolk NR26 8JA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Hilda Stephenson     Date: 0 9 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Whitehaven 5 St. Josephs Road Sheringham Norfolk NR26 8JA 01263822706 01263822706 bharj@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Holly Care Limited - Harmesh K Bharj Name of registered manager (if applicable) Mrs Harmesh K Bharj Type of registration: Number of places registered: care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 14 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP Learning Disabilty Code LD Date of last inspection Brief description of the care home Whitehaven is a detached house located in a quiet residential street about a mile from the centre of Sheringham. It caters for fourteen elderly service users in ten single and two shared rooms on the ground and first floors of the house. Four of the rooms have en suite facilities. A shaft lift provides assistance. The current owner who also runs the Care Homes for Older People Page 4 of 26 Over 65 1 13 0 0 Brief description of the care home Home has been registered since October 2009. The current fee for living at the home is from £366-400 per week. There is an additional fee for personal items such as toiletries, hairdresser, chiropodist, newspapers, dentist and outings. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of the inspection undertaken by the Quality Care Commission is upon outcomes for people who use the service and their views on the service provided. The process considers the providers capacity to meet regulatory requirements, minimum standards of practice, and focuses on aspects of service provision that needs further development. One inspector conducted the unannounced visit. The main method of inspection used is called case tracking which involves selecting people who use the service and looking at the quality of care they receive by speaking to them, observation, reading their records and asking staff about their needs. The manager who also owns the home and two members of staff were spoken with as part of the visit, records relating to medication management was also inspected to Care Homes for Older People Page 6 of 26 form an opinion about the quality of care provided. A partial tour of the building was undertaken which included peoples bedrooms and communal areas they frequent to make sure that the environment is homely and safe. A review of all the information we have received about the home was considered in planning this visit which included the Annual Quality Assurance Assessment and notifications which was provided by the manager. The service was assessed as acheiving a two star rating. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 26 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. New residents are given the written information and have their care needs assessed to enable them to make a decision about moving in. Evidence: The manager explained the admission procedure of new residents wishing to move into the home. The manager would visit each person who considers Whitehaven to discuss their individual care needs and discusses the facilities and services offered at the home. There is detailed written information regarding the service, the fees and extras to be paid and what each person can expect. The evidence was confirmed by speaking to the last person admitted to the home. The care records of the admission process was seen which included their individual care and social needs alongside the relevant risk assessments and support for them to maintain their dependency level. The written information was also left in each bedroom. Care Homes for Older People Page 11 of 26 Evidence: The resident was spoken to regarding their admission to the home and this confirmed that they were included with all the admission procedure, obtaining support from their social worker as well as the manager. The required contract and care records were signed by the resident and their advocate showing the practice was good. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents will have a comprehensive care plan of their individual needs and have access to health care. Evidence: Two care records were read during this inspection and both residents were spoken to regarding the care and support they were receiving from the staff. One of the residents had lived at the home for several years and confirmed that the care and support that they received was very good. Saying the staff are extremely helpful. There was evidence of visits from other professionals and the manager confirmed that they receive good support from the district nurses who visit each day. All residents have access to other health professionals such as the dentist, chiropodist and attending hospital appointments. There was evidence that extra equipment had been sought for residents who were frailer and required specialist care. Care Homes for Older People Page 13 of 26 Evidence: Both the residents spoken to were happy with the care and attention that was provided by the staff and visiting professionals to the home. The medication charts for the two residents were seen, these provided evidence of a safe system of ordering, administering and returning medication. Staff records showed that staff who administer medication has undergone training and an update had been organised for them for the following month. The new owner had recently obtained a portable lockable cabinet and medication is stored within this, with extra medicines stored securely. The medication policy had recently been rewritten and staff showed they understood these procedures. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged to maintain sociable contact with relatives and friends and have a wholesome menu offered. Evidence: The staff organise activities after tea time, which appeared to be the result of their wishes from the quality survey. The manager said several of the residents go out with their relatives, either for tea or to the local shops or a drive. If any residents wishes to go to the shops then a member of staff can do this, as the manager stands in for them on the floor. A weekly activity list was displayed in the dining room. The lounge was not used by any residents during the day of the visit, although several were seen sitting in the dining room. Residents who were spoken to during this visit confirmed that they prefer to stay in there own rooms to watch television or listen to the radio, or read. Newspapers were delivered for those who requested it. One resident walks to the shop each morning to collect their own paper. The manager said that the local clergy visits on a regular basis to continue holy communion for residents. One resident plays the piano and they organise a singalong Care Homes for Older People Page 15 of 26 Evidence: on an ad hoc basis. It was recommended the manager organises the library to drop off a selection of books for residents to choose. The menu is over a four weekly rota. The meals were nutritious and wholesome, using a selection of fresh fruit and vegetables, supplied by local services. The cook usually offers one main dish for lunch and asks residents each day if they wish for that or an alternative. The kitchen has been refurbished since the home changed hands and has been awarded a five star status from the Environmental Health Office. On the cooks days off the manager or senior carer cooks and prepares the meals. Every resident spoken to confirmed the meals were excellent. The dining room is laid out as one long table, with a small table at the end for residents who require assistance. Lunch time was used as a sociable occasion, when the majority of the residents sat together. The same goes for tea time too. The staff have all acquired the food hygiene certificate. which also should be commended. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected and have their views and opinions listened to. Evidence: The complaints procedure was displayed and contained within the written information in each residents room. When speaking with residents and staff there were no concerns about the service highlighted. The new owner had not had any complaints to deal with. Staff have received adult protection training and when speaking with them during this visit they confirmed they understood how to protect vulnerable people. The owner had rewritten the relevant policies and these were seen during this visit. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, comfortable clean environment. Evidence: Whitehaven is situated within a quiet street a few minutes walk from the main shopping area of Sheringham. It is a town house adapted to accommodate wheelchairs users. There are ramps to both front and rear doors with access to the first floor by shaft lift. The bedrooms vary in size and the majority of rooms have an en suite. There is a bathroom with chair hoist on both floors. The ground floor contains the large lounge and dining room. The home has two shared rooms, although one of these is currently being used as a single bedroom. Since the new owners have been in situ they have refurbished several bedrooms and changed the carpet in three of these. The kitchen has been completely renewed and has recently been awarded a five star status by the Environmental Health Office, and they should be commended for this. Four of the bedrooms were seen and these contained residents personal possessions and were very individualised. All of the residents spoke positively about the improvements made since the home changed hands. Some areas of the home were Care Homes for Older People Page 18 of 26 Evidence: still in need of upgrading, although the manager shared details of the continuous improvement plan in place. The home does not have office space for staff to keep records, and staff handover is mainly carried out in the dining room, the manager spoke of plans to change this so residents communal space wont be compromised in the future. Staff continue to undertake residents personal laundry and adequate facilities are in place. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are cared for by adequate numbers of well trained staff. Evidence: The rota showed that the home is covered by two care staff until 10pm. The manager also works on the floor and cooks during times of shortages. There is adequate numbers of staff to care for the number and dependency levels of the current residents, with senior staff covering periods when the manager is absent. There is one waking night staff on overnight with the manager being on call for emergency cover or assistance. Residents spoken to said they thought there were enough staff on duty and that they did not wait long for the call bell to be answered by the staff. Extra staff are brought in during periods of keeping appointments, outings or the manager covers these. The staff do not have a separate office to keep confidential records or have meetings, the records are secure within a locked cupboard, this is a disadvantage for them and the manager is considering adapting the environment to add an office for this purpose. The dining room seems to be used for staff handover reducing the residents options Care Homes for Older People Page 20 of 26 Evidence: for sitting in their own home, although the manager has plans in place for improvement. Staff spoken to confirmed they receive good support from the new manager and have attended several courses for them to keep up to date with trends and policies. Out of the six care staff all six have obtained the recommended vocational qualification in care at level two and this should be commended, with several of the senior staff signing up for the next level. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe well managed home. Evidence: Harmesh Bharj is the new owner and also manages the home. She previously managed a small home in elsewhere in the country. She has the NVQ level 4 in management and has several years experience in caring for older people. She has introduced new care plans and rewritten all the homes policies and procedures as well as completely refurbishing the kitchen, three bedrooms, and has improvement plans for several other areas such as an office, bathroom and bedrooms. She holds staff meetings and residents meetings with minutes recorded for those who did not attend. Since she took over the home she has also undertaken a quality survey with results, showing evidence of improving the care for residents, environment and training of the staff. The manager holds secure records of residents personal spending money, and records Care Homes for Older People Page 22 of 26 Evidence: were checked with her. The resident and staff member sign the notebook regarding the balance to eliminate mistakes. Staff supervision takes place and these records are held in each staff files. Three of these were seen. Mr Bharj oversees the health and safety, and checks to the environment. Records of fire, water temperatures, boiler maintenance, security, COSHH, infection control, moving and handling, lift maintenance, current insurance and the registration certificate were seen. All having been maintained since the changeover. Improvement plans were in place and discussed during this visit. The home needs an office area for the staff to work from and be able to have confidential meetings rather than using the dining room. Otherwise, this appears to be a well managed small home. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 12 19 The manager should organise the local library to visit to offer books for residents to read. There are still some areas of the home that require redecoration and improvement such as the dining room and upstairs bathroom. The manager should consider adapting space to provide an office or area that confidential meetings can take place, rather than the current practice of using the communal rooms. 3 31 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!